The late queen of keepin’ it real, Nora Ephron wasn’t alone when she titled her 2006 best-seller, “I Feel Bad About My Neck.” In fact, as we age it’s a strong bet that many of us will start to feel “bad” about our necks — and for good reason. A once swanlike neck that starts to accumulate fat, wrinkles and vertical banding as we grow older is hardly the stuff of dreams. And when that tight as a baby’s bottom jawline starts to display jowls, a double chin, and/or sagging neck skin or “turkey wattle” you’ll need that neck scarf to wipe away the tears.

The sweet bird of youth may have flown the coop, but you don’t necessarily have to cope with it. Ephron chose to address her neck issues by sporting turtlenecks and putting a pen to paper to help us commiserate, but there are other more proactive approaches one can take — like visiting your plastic surgeon in San Francisco to discuss the combo of procedures available, collectively referred to as a neck lift.

Not exactly a “one-size-fits-all” procedure, a neck lift is meant to improve the appearance of the neck by tightening the skin and underlying muscles and by enhancing the contour of the jawline through a combination of procedures aimed at producing a tighter and more youthful appearance. Doctors typically rely on a combination of liposuction, platysmaplasty and cervicoplasty to achieve the desired results.

For example, a patient with only a small amount of excess fat under the chin may only require liposuction while other patients, particularly those with banding or a “turkey wattle” may benefit from platysmaplasty, which adjusts the platysma muscle that crisscrosses the neck. Still other patients may require cervicoplasty to address loose sagging neck skin or along the jawline. The latter two, being more invasive and lengthy procedures, will likely result in a longer recovery time, and oftentimes are done in-tandem with other facial rejuvenation procedures such as Ultherapy Laser Skin Tightening or the Fraxel Laser procedure.

The pros are self-evident: an improved neck, jawline and even profile.

The cons: bruising and swelling, your neck may feel tight for a few months after the procedure, and your neck will look so darn fabulous that other signs of aging may appear more prominent.

A consultation with your local plastic surgeon [Dr. Usha Rajagopal] will help determine which procedures will offer the most benefit for you depending on a combination of factors, including: the laxity of your skin, your own fat accumulation, your expectations, and your general health.

So if you’re feeling “bad about your sagging neck skin,” don’t hide away in a turtleneck sweater and pen an essay about your endless suffering. Instead, simply make an appointment with Dr. Usha Rajagopal at the San Francisco Plastic Surgery and Laser Center and talk about today’s wide variety of surgical and non -surgical options. Your neck will thank you.